Life-changing UK health program could reach more families with better coordination and resources, says study

New research from City, University of London and the University of Southampton highlights the importance of Healthy Start for low-income families and outlines several recommendations for local and national governments to improve uptake of the scheme.

The study was led by Professor Christina Vogel, Director of the Centre for Food Policy at City, University of London. This work aimed to evaluate the Healthy Start scheme in England and understand how the scheme can be improved to reach more eligible families.

The Healthy Start scheme was launched in 2006. It offers financial support and free vitamins for pregnant women and families with children under four years of age who are living on a low income, as defined by the eligibility criterion. Prior to March 2022, families were offered paper vouchers, but the financial component of the scheme is now a digital prepayment card.

The research shows that digitalization has improved usability of the scheme for most people. Currently around 366,000 families have received the prepayment card; of 506,309 total families who are currently eligible. Cardholders receive £4.25 per week per child or per week of pregnancy (or £8.50 per week per child from birth to 1 year) and can use their Healthy Start prepayment card to buy fruit, vegetables, milk, infant formula and beans.

Project manager and lead author of the paper Millie Barrett said, “Healthy Start has been described to us as ‘life-changing,’ ‘transformational,’ and a ‘lifeline’ for families who struggle to afford basic healthy foods. Given that a fifth of all children in the UK are living in food-insecure households and this policy can help, the commissioned work has led us to hear from a large number of people to better understand why Healthy Start uptake remains suboptimal and identify what can be done to increase its use.”

The work involved hearing from more than 100 people across England who promote, implement or use the scheme, including health professionals, retailers and eligible families. The findings show that across the system people universally support Healthy Start and view it as vital support for pregnant women and families living on a low income.

But with 3.5 people in every 10 eligible still not using Healthy Start, those interviewed believed that reframing the scheme as a child’s right to good food and healthy development—rather than a benefit, voucher or handout—could improve uptake. They also wanted promotional efforts to be better coordinated and sufficiently resourced so eligible families can have a helping hand to complete the application with people they trust and in places they regularly visit, like community or children’s centers or places of worship.

Full details of the study, including the seven recommendations, are presented in BMC Medicine.

Professor Christina Vogel, Director of the Centre for Food Policy at City, University of London, said, “Our study highlights the importance of the scheme and ways in which efforts to implement Healthy Start locally and nationally could be better coordinated so more families can benefit. In the context of ever-widening health inequalities in the UK, there should be no delay in the implementation of the recommendations that have come out of our study. Healthy Start is a much-loved and appreciated scheme that helps give all children a chance at the best start in life.”